Mesothelioma is most common in Australia, New Zealand, and the industrialized nations of Northern and Western Europe, with the United Kingdom and Luxembourg reporting the highest individual country rates. These regions share a common thread: heavy industrial asbestos use during the mid-20th century, with cases appearing decades later due to the cancer’s long latency period of 20 to 50 years.
Regions With the Highest Rates
According to GLOBOCAN data from the International Agency for Research on Cancer, the Australia-New Zealand region has the highest age-standardized incidence and mortality rates for mesothelioma in the world. Northern Europe ranks second, followed by Western Europe and Southern Europe. Southern Africa, Eastern Europe, Western Asia, and Northern America round out the top regions.
At the country level, Luxembourg has the highest recorded incidence rate at 2.0 per 100,000 people. The United Kingdom follows at 1.3 per 100,000 for incidence but leads the world in raw mortality, with 3.0 deaths per 100,000. The UK’s high numbers reflect decades of shipbuilding, construction, and manufacturing that relied heavily on asbestos before its ban took full effect in 1999. Australia’s rates trace back to extensive mining operations, particularly the crocidolite (blue asbestos) mine in Wittenoom, Western Australia, which operated from 1943 to 1966.
Known Hotspots and Exposure Clusters
Certain towns and cities have mesothelioma rates far above their national averages, typically because of a single factory or mine that contaminated the surrounding area for decades.
Casale Monferrato in northwest Italy is one of the most studied examples. The town was home to the largest asbestos cement plant in Italy, owned by Eternit, which operated from 1907 to 1986. The contamination extended well beyond factory workers. In nearby Frassineto Po, a small family-run business recycled used jute bags from the Eternit plant through the 1950s to 1970s. In Cella Monte, residents paved private roads, paths, and courtyards with crushed asbestos cement waste. Both towns developed elevated cancer clusters as a result. Broni and Bari, two other Italian cities with large asbestos cement factories, show similarly high rates among people who never worked in the plants but simply lived nearby.
In Amagasaki, Japan, researchers found that people who lived within 300 meters of an asbestos products factory had dramatically elevated mesothelioma death rates. Women in that radius were more than 40 times as likely to die from the disease as expected. Significantly elevated rates extended out to 2,200 meters from the plant, showing how far environmental contamination can reach.
Why Men Are Affected More Often
Globally, men develop mesothelioma about 2.5 times more often than women, largely because occupational asbestos exposure was concentrated in male-dominated industries like construction, shipbuilding, and mining. In an analysis of over 21,000 cases from Italy’s national registry, the female-to-male ratio was 0.40 overall and dropped to 0.38 for the pleural (lung lining) form, which is most closely tied to workplace inhalation.
The gender gap narrows in countries where environmental rather than occupational exposure drives the disease. Turkey stands out: 43.5% of mesothelioma deaths there are female, the highest proportion among 36 countries studied. This reflects Turkey’s naturally occurring asbestos deposits, particularly erionite fibers in the Cappadocia region, which expose entire communities regardless of occupation. South American and Eastern European countries show a similar pattern, where a higher share of female cases corresponds to lower overall rates, suggesting the exposure is environmental rather than industrial. Denmark sits at the opposite extreme, with only 10.6% of deaths occurring in women, consistent with a pattern driven almost entirely by workplace exposure in heavy industry.
Countries Still Using Asbestos
While more than 60 countries have banned asbestos, global consumption still ranges between 1.1 and 1.3 million tons per year. Russia is by far the largest producer, mining an estimated 630,000 tons in 2023. Kazakhstan produced 260,000 tons, and China produced 200,000 tons. Demand remains strong in parts of Asia, where asbestos is still used in cement pipes, roofing sheets, and other construction materials.
The United States has reduced its consumption from a peak of 803,000 tons in 1973 to roughly 150 tons in 2023, all drawn from existing stockpiles. An EPA rule proposed in 2022 would ban all remaining commercial uses of chrysotile asbestos once finalized. But the long latency of mesothelioma means that past exposure continues to generate new cases for decades after use stops. Countries that are still consuming asbestos at high volumes today are likely building a wave of future cases that won’t appear for another 20 to 50 years.
The True Global Burden Is Unknown
The countries that report the highest mesothelioma rates are also the ones with the best diagnostic infrastructure and cancer registries. This creates a significant blind spot. Mesothelioma is grossly underreported in many developing countries, including some with extensive histories of asbestos use. The reasons compound on each other: limited access to pathology labs capable of confirming the diagnosis, low awareness among physicians who may attribute symptoms to tuberculosis or other lung diseases, and weak or nonexistent cancer reporting systems.
There is also a political dimension. Some countries that produce and export asbestos have little incentive to document the diseases it causes. Researchers have noted that even when cases are diagnosed domestically, the data may not be shared internationally, particularly as more countries adopt bans and the global pressure against asbestos trade increases. This means the global map of mesothelioma is less a picture of where the disease occurs and more a picture of where it gets counted. The actual geographic distribution is almost certainly broader and more evenly spread than current data suggest.
Survival Remains Low Worldwide
Regardless of where it’s diagnosed, mesothelioma carries a poor prognosis. Data from the Nordic countries (Denmark, Finland, Norway, and Sweden) show that one-year relative survival has improved over recent decades, rising from about 20% to roughly 50%. But five-year survival has remained stubbornly at or below 10% for both men and women. This pattern holds across most healthcare systems. The improvement in short-term survival likely reflects better supportive care and earlier detection in some cases, but the underlying biology of the cancer has proven difficult to overcome with current treatments.